Trevathan’s “New Kneecap”: Answers About Broncos Linebacker’s Surgery
June 17 8:47pm
Will Carroll
“I’ve got someone else’s kneecap.”
I’m used to hearing some odd things come from a player’s mouth
when talking about injuries, but Danny Trevathan took me by surprise with
this gem, reported by
Mike Klis of the Denver Post. Trevathan does appear to be accurate and while the Denver Broncos wouldn’t
comment on record about the specifics of Trevathan’s surgery, our
team was able to piece together some of the specifics.
The fact is that Trevathan still has his own kneecap, augmented by a bone
graft. FanDuel’s Michael Schottey spoke with sources in the Broncos
organization, confirming
Troy Renck’s report that Trevathan did not have a transplant or even an allograft, the introduction
of bone from a cadaver.
Trevathan first injured his knee during training camp 2014. He had a small
fracture of his patella (kneecap) and missed most of training camp, plus
the first four weeks of the season while it healed. Once back, he didn’t
stay healthy long, having the same knee dislocate, ending his season.
Patellar dislocation is extremely painful and damaging, but easily correctable.
In most cases, the groove behind the patella needs to be fixed and the
motion of the knee corrected. This can be accomplished a number of ways,
shaping and augmenting the surface. In most cases, a fracture will need
to be fixated with pins, screws, or even a cage. This latter was performed
on Kyrie Irving of the Cleveland Cavaliers after
fracturing his patella during the NBA Finals.
The real issue is normally the soft tissue surrounding the knee that complements
its motion. The patellar tendon, especially, is involved and can be damaged
when the patella goes rogue, stretching and tearing the connections and
changing the biomechanics. If left uncorrected, the knee can lose function
and stability.
For many, including older patients with degenerative changes, a partial
knee arthroplasty is an option. Unlike a complete knee replacement, in
a partial, one or two of the three components of the knee’s osseous
structures are replaced. Many former NFL players will have knee replacement,
including the
famous knees of Joe Namath. However, none to this point have been able to play after having any type
of arthroplasty.
In fact, there are very few athletes that have even attempted such a thing.
There are three cases in baseball. Bo Jackson famously returned to MLB
after injuring his hip playing football just a year after a complete replacement.
Colby Lewis, a pitcher for the Texas Rangers, also returned after a modified
hip replacement. A minor leaguer had a meniscal transplant and had no
issues after the surgery, but did not make it to the major leagues on talent.
There is not a known case of the more common osteochondral allograft in
major professional sports. This operation is about as involved as any
currently performed, but even with the extensive use of microfracture,
no players have elected for this type of procedure.
So did Trevathan even have an opportunity to have a first-of-it’s-kind
procedure? According to one NFL team physician who could not speak on
the record due to NFL rules, the answer is simple: no. “A patellar
transplant? I think [Trevathan] skipped medical classes back at Kentucky,”
he joked. The doctor explained that there’s an institutional resistance
to unproven procedures in sports. “He’s too good to experiment
on,” he explained.
Dr. Bert Mandelbaum, one of the top orthopedic surgeons in the country
from Santa Monica Orthopaedic concurred. “I think it is imperative
that we find out exactly what procedure was done on this athlete. Prior
to that, it is difficult to create a hypothetical and respond accordingly.
I think it is essential that we have the information of what a new kneecap
means? Does it mean he had plastic and metal or osteochondral allografts?
Does it mean he had a regenerative articular cartilage procedure? We need
more information!”
Now that we know that Trevathan was confused about his procedure, it doesn’t
change the fact that Trevathan has made a nice, standard recovery from
a surgical procedure with an extensive track record. Rather than hoping
that an experimental procedure would keep their linebacker healthy, the
Broncos head into a key training camp with the expectation that Trevathan
will be available.
And with his own repaired kneecap.
Michael Schottey contributed additional reporting to this piece.